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Wilson SD, Jackson J, Halling C, DiBartolomeo M. Beyond cord clamping: Complexities of umbilical cord management after birth. Semin Perinatol 2023:151784. [PMID: 37357043 DOI: 10.1016/j.semperi.2023.151784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
The benefits of delayed cord clamping have been investigated in multiple studies and supported by various professional associations. Other aspects of umbilical cord management strategies occurring after cord clamping have not been fully thoroughly analyzed. This article will explore and deliberate elements of umbilical cord nonseverance, vascular access management, and blood banking.
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Affiliation(s)
- Sheria D Wilson
- Nationwide Children's Hospital, Columbus, Ohio, U.S.A.; The Ohio State University College of Medicine, Department of Pediatrics, Division of Neonatology, Columbus, Ohio, U.S.A.; The Ohio State University College of Medicine, Department of Biomedical Education and Anatomy, Division of Bioethics, Columbus, Ohio, U.S.A..
| | - Jason Jackson
- Nationwide Children's Hospital, Columbus, Ohio, U.S.A.; The Ohio State University College of Medicine, Department of Pediatrics, Division of Neonatology, Columbus, Ohio, U.S.A
| | - Cecilie Halling
- Nationwide Children's Hospital, Columbus, Ohio, U.S.A.; The Ohio State University College of Medicine, Department of Pediatrics, Division of Neonatology, Columbus, Ohio, U.S.A
| | - Mara DiBartolomeo
- Johns Hopkins All Children's Hospital, St. Petersburg, Florida; Maternal, Fetal & Neonatal Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, U.S.A
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2
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Bowman TP, Deshpande A, Balfour A, Harvey‐Wood K. Staphylococcus lugdunensis
in children: A retrospective analysis. Pediatr Investig 2022; 6:163-170. [PMID: 36203510 PMCID: PMC9523813 DOI: 10.1002/ped4.12345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/19/2022] [Indexed: 11/06/2022] Open
Abstract
Importance Staphylococcus lugdunensis (S. lugdunensis) is a coagulase‐negative staphylococcus (CoNS), found commonly as skin flora in humans. While most species of CoNS are clinically benign, S. lugdunensis can exhibit a similar virulence to that of S. aureus. However, there is scant data concerning S. lugdunensis infection in the pediatric population. Objective To ascertain local S. lugdunensis infection rates and sensitivity patterns in the pediatric population. Methods A retrospective analysis was undertaken of all S. lugdunensis isolates across a 6‐year period from 2015 to 2020. Data were collected from electronic patient notes and laboratory records. Matrix‐assisted laser desorption ionization and time of flight mass spectrometry were used to identify isolates. Results Ninety‐six isolates of S. lugdunensis were identified from 86 patients. Of these, 34 isolates were treated as an infection. Twenty‐three (67.6%) were found to have skin as the primary source of infection. While the observed number was small, central nervous system (CNS) sources of S. lugdunensis infection appear to be a significant source: all three isolates cultured from cerebrospinal fluid were clinically managed as infection. All three were associated with ventriculoperitoneal (VP) shunt infection. No cases of S. lugdunensis infective endocarditis were identified. About 18.6% of S. lugdunensis isolates were resistant to flucloxacillin. Interpretation S. lugdunensis is an uncommon but significant cause of infection in the pediatric population and appears to be a rising cause of CNS infection, particularly when associated with VP shunts. Flucloxacillin is recommended locally as the first choice of antibiotic.
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Affiliation(s)
| | - Ashutosh Deshpande
- Department of Microbiology Queen Elizabeth University Hospital Glasgow UK
| | - Alison Balfour
- Department of Microbiology Queen Elizabeth University Hospital Glasgow UK
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BATUHAN KARAŞIN F, KIZILKAYA T. Plasentaya Spiritüel Yaklaşım: Lotus Doğum. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.863314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Nolt D, O’Leary ST, Aucott SW. Risks of Infectious Diseases in Newborns Exposed to Alternative Perinatal Practices. Pediatrics 2022; 149:184545. [PMID: 35104357 PMCID: PMC9645715 DOI: 10.1542/peds.2021-055554] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The purpose of this report is to educate providers about the risk of infectious diseases associated with emerging alternative peripartum and neonatal practices. This report will provide information pediatricians may use to counsel families before birth and to appropriately evaluate and treat neonates who have been exposed to these practices.
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Affiliation(s)
- Dawn Nolt
- Division of Infectious Diseases, Department of Pediatrics, Oregon Health and Science University, Portland, Oregon,Address correspondence to Dawn Nolt, MD, MPH.
| | - Sean T. O’Leary
- Divisions of Infectious Diseases and General Academic Pediatrics, Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus/Children’s Hospital Colorado, Aurora, Colorado
| | - Susan W. Aucott
- Division of Neonatology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
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5
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Staphylococcus lugdunensis Bacteremia with an Infected Aortic Thrombus in a Preterm Infant. CHILDREN 2022; 9:children9010046. [PMID: 35053671 PMCID: PMC8774124 DOI: 10.3390/children9010046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/13/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022]
Abstract
Staphylococcus lugdunensis is a rare cause of late-onset sepsis in preterm infants. To our best knowledge, we report the fourth case of a male preterm infant who developed fulminant late-onset sepsis due to Staphylococcus lugdunensis with persistent bacteremia secondary to an infected aortic thrombus confirmed with two positive blood cultures. Our patient was an extremely low birth weight growth-restricted infant born at 27 weeks gestation and initially required an umbilical arterial catheter for blood pressure and blood gas monitoring. The course of this neonate was complicated by severe respiratory distress syndrome that evolved into chronic lung disease along with multiple episodes of tracheitis. Hemodynamically, the infant had a significant patent ductus arteriosus, and an episode of medical necrotizing enterocolitis followed by Staphylococcus lugdunensis septicemia. He was diagnosed with an infected aortic thrombus, probably the occult focus responsible for the persistent bacteremia. After a 6-week course of intravenous antibiotics and 4-week course of anticoagulant therapy, the infant responded and recovered without complications.
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Hurvitz N, Cahan LOS, Gross I, Grupel D, Megged O, Pasternak Y, Temper V, Levy R, Weiser G, Hashavya S. The role of Staphylococcus lugdunensis as a pathogen in children: a multicentre retrospective study. J Med Microbiol 2021; 70. [PMID: 34038340 DOI: 10.1099/jmm.0.001357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Staphylococcus lugdunensis (SL), a tube coagulase negative Staphylococcus, is known to be pathogenic in adults, causing mainly skin infections.Gap Statement: Previous studies assessing SL's role in paediatric populations are sparse and are mainly limited to case reports.Aim: Present the clinical characteristics consistent with SL infections and its putative role as a pathogen in the paediatric population.Methodology: A retrospective multicentre study was conducted in four paediatric medical centres in Israel. Patients with isolates of SL presenting between 2009-2019 were included.Results: SL was isolated from 40 patients. Average (±SD) age at presentation was 5.9 (±6.2) years, with 22 (55 %) being female. Skin, soft tissue and musculoskeletal infections were the most common (n=20, 50%) followed by ear infections (n=13, 32.5%). Five cases of urine isolates and two isolates from blood culture samples were also reported. Skin abscess was the most common infection among skin and soft tissue isolates, reported in 17 children (85%) with SL being the only pathogen in 15 (75%). Otitis media was the most common ear infection accounting for 12 (92%) of all cases with SL as the only isolate reported in 6 (46%). Five cases of SL isolates from urine specimens were reported, all of which with poor growth of bacteria and normal urinalysis. Two cases of SL growth in blood culture were found in children presenting with signs and symptoms consistent with invasive blood stream infection.Conclusions: In the paediatric population, studied infections caused by SL are increasingly observed. The results of this study highlight its role as a pathogen in soft tissue infections and its putative role in otitis media and invasive blood stream infections. However, the role of SL as an uropathogen was not established.
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Affiliation(s)
- Noa Hurvitz
- Faculty of Medicine, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel
| | | | - Itai Gross
- Department of Paediatric Emergency Medicine, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel
| | - Daniel Grupel
- Department of Infectious Diseases, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Orli Megged
- Faculty of Medicine, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel.,Department of Paediatrics and Paediatric Infectious Diseases Unit, Shaare Zedek Medical centre, Jerusalem, Israel
| | - Yehonatan Pasternak
- Schneider Children's Medical Centre in Israel, Ward A, Paediatrics, Sackler School of Medicine, Tel Aviv University, Petah Tikva, Israel
| | - Violeta Temper
- Department of Microbiology, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel
| | - Rachel Levy
- Schneider Children's Medical Centre in Israel, Ward A, Paediatrics, Sackler School of Medicine, Tel Aviv University, Petah Tikva, Israel
| | - Giora Weiser
- Department of Paediatric Emergency Medicine, Shaare Zedek Medical centre, Jerusalem, Israel
| | - Saar Hashavya
- Department of Paediatric Emergency Medicine, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel
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Lisowska-Łysiak K, Lauterbach R, Międzobrodzki J, Kosecka-Strojek M. Epidemiology and Pathogenesis of Staphylococcus Bloodstream Infections in Humans: a Review. Pol J Microbiol 2021; 70:13-23. [PMID: 33815523 PMCID: PMC8330453 DOI: 10.33073/pjm-2021-005] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/18/2021] [Accepted: 01/12/2021] [Indexed: 01/19/2023] Open
Abstract
Staphylococci are among the most frequent human microbiota components associated with the high level of bloodstream infection (BSI) episodes. In predisposed patients, there is a high risk of transformation of BSI episodes to sepsis. Both bacterial and host factors are crucial for the outcomes of BSI and sepsis. The highest rates of BSI episodes were reported in Africa, where these infections were up to twice as high as the European rates. However, there remains a great need to analyze African data for comprehensive quantification of staphylococcal BSI prevalence. The lowest rates of BSI exist in Australia. Asian, European, and North American data showed similar frequency values. Worldwide analysis indicated that both Staphylococcus aureus and coagulase-negative staphylococci (CoNS) are the most frequent BSI agents. In the second group, the most prevalent species was Staphylococcus epidermidis, although CoNS were not identified at the species level in many studies. The lack of a significant worldwide decrease in BSI episodes indicates a great need to implement standardized diagnostic methods and research etiological factors using advanced genetic methods.
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Affiliation(s)
- Klaudia Lisowska-Łysiak
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Ryszard Lauterbach
- Department of Neonatology, Collegium Medicum, Jagiellonian University, Kraków, Poland
| | - Jacek Międzobrodzki
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Maja Kosecka-Strojek
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
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Noshak MA, Rezaee MA, Hasani A, Mirzaii M. The Role of the Coagulase-negative Staphylococci (CoNS) in Infective Endocarditis; A Narrative Review from 2000 to 2020. Curr Pharm Biotechnol 2020; 21:1140-1153. [PMID: 32324510 DOI: 10.2174/1389201021666200423110359] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/12/2020] [Accepted: 04/02/2020] [Indexed: 12/15/2022]
Abstract
Coagulase-negative staphylococci (CoNS) are part of the microbiota of human skin and rarely linked with soft tissue infections. In recent years, CoNS species considered as one of the major nosocomial pathogens and can cause several infections such as catheter-acquired sepsis, skin infection, urinary tract infection, endophthalmitis, central nervous system shunt infection, surgical site infections, and foreign body infection. These microorganisms have a significant impact on human life and health and, as typical opportunists, cause peritonitis in individuals undergoing peritoneal dialysis. Moreover, it is revealed that these potential pathogens are mainly related to the use of indwelling or implanted in a foreign body and cause infective endocarditis (both native valve endocarditis and prosthetic valve endocarditis) in patients. In general, approximately eight percent of all cases of native valve endocarditis is associated with CoNS species, and these organisms cause death in 25% of all native valve endocarditis cases. Moreover, it is revealed that methicillin-resistant CoNS species cause 60 % of all prosthetic valve endocarditis cases. In this review, we describe the role of the CoNS species in infective endocarditis, and we explicated the reported cases of CoNS infective endocarditis in the literature from 2000 to 2020 to determine the role of CoNS in the process of infective endocarditis.
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Affiliation(s)
- Mohammad A Noshak
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad A Rezaee
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Medical Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alka Hasani
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Medical Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Mirzaii
- Department of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
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Svedenkrans J, Aquilano G, Pettersson K. A Case of Severe Infant-to-Placenta Hemorrhage in Association with Prolonged Delayed Cord Clamping. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e925116. [PMID: 33130804 PMCID: PMC7643584 DOI: 10.12659/ajcr.925116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Patient: Male, newborn Final Diagnosis: Hemorrhage Symptoms: Hemorrhagic shock • respiratory distress Medication: — Clinical Procedure: Blood transfusion • CPAP treatment • head scan • saline bolus Specialty: Pediatrics and Neonatology
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Affiliation(s)
- Jenny Svedenkrans
- Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institute, Stockholm, Sweden.,Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Giulia Aquilano
- Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Pettersson
- Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institute, Stockholm, Sweden
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Gönenç İM, Aker MN, Ay E. Qualitative Study on the Experience of Lotus Birth. J Obstet Gynecol Neonatal Nurs 2019; 48:645-653. [PMID: 31563441 DOI: 10.1016/j.jogn.2019.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe the experiences of women who had lotus births, that is, leaving the umbilical cord uncut so that the placenta remains attached to the newborn until the umbilical cord naturally detaches. DESIGN Descriptive phenomenological. SETTING Seven cities in four geographic regions of Turkey. PARTICIPANTS Nine women who experienced lotus birth. METHODS Data were collected through semistructured, face-to-face interviews. RESULTS Our analysis revealed six themes: Meaning of the Lotus Birth Experience, Decision Making Regarding Lotus Birth, Lotus Birth Process, Perceived Benefits and Disadvantages of Lotus Birth, Reactions to Lotus Birth, and The Future of Lotus Birth. In addition, we created 15 subthemes related to these overarching themes. CONCLUSIONS The themes we extracted are reflective of the desire for a natural and healthy birth that is experienced as positive and beneficial. Our results contribute to a deeper and more nuanced understanding of lotus birth. Moreover, our findings provide women and all health care providers, especially maternity nurses, with valuable information and increased awareness of lotus birth.
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Bonsignore A, Buffelli F, Ciliberti R, Ventura F, Molinelli A, Fulcheri E. Medico-legal considerations on "Lotus Birth" in the Italian legislative framework. Ital J Pediatr 2019; 45:39. [PMID: 30885231 PMCID: PMC6423792 DOI: 10.1186/s13052-019-0632-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 03/13/2019] [Indexed: 12/26/2022] Open
Abstract
The term “Lotus Birth” identifies the practice of not cutting the umbilical cord and of leaving the placenta attached to the newborn after its expulsion until it detaches spontaneously, which generally occurs 3–10 days after birth. The first reported cases of Lotus Birth date back to 2004 in Australia. Supporters of such a procedure claim that the newborn is better perfused, endowed with a more robust immune system and “less stressed”. However, it should be pointed out that histopathological study of the placenta is increasingly being requested in order to investigate problems of an infective nature or dysmaturity affecting the foetus, and situations of risk affecting the mother. Moreover, from the legal standpoint, there is no uniform position on the question of whether the placenta belongs to the mother or to the newborn. Lastly, a proper conservation of the embryonic adnexa is very difficult and includes problems of a hygiene/health, infectivological and medico-legal nature. The authors analyzed all these aspect in the Italian legislative framework, reaching the conclusion that Lotus Birth is inadvisable from both the scientific and logical/rational points of view.
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Affiliation(s)
- Alessandro Bonsignore
- Department of Health Sciences (DISSAL) - Section of Legal and Forensic Medicine and Bioethics, University of Genova, Via De Toni 12, 16132, Genoa, Italy.
| | - Francesca Buffelli
- Ph.D Course in Paediatric Science, Fetal-Perinatal and Paediatric Pathology, University of Genova, Genoa, Italy.,Fetal and Perinatal Pathology Unit, IRCCS Istituto Giannina Gaslini, Largo G. Gaslini, 16147, Genoa, Italy
| | - Rosagemma Ciliberti
- Department of Health Sciences (DISSAL) - Section of Legal and Forensic Medicine and Bioethics, University of Genova, Via De Toni 12, 16132, Genoa, Italy
| | - Francesco Ventura
- Department of Health Sciences (DISSAL) - Section of Legal and Forensic Medicine and Bioethics, University of Genova, Via De Toni 12, 16132, Genoa, Italy
| | - Andrea Molinelli
- Department of Health Sciences (DISSAL) - Section of Legal and Forensic Medicine and Bioethics, University of Genova, Via De Toni 12, 16132, Genoa, Italy
| | - Ezio Fulcheri
- Fetal and Perinatal Pathology Unit, IRCCS Istituto Giannina Gaslini, Largo G. Gaslini, 16147, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC) - Pathology Division of Anatomic Pathology, University of Genova, Largo Rosanna Benzi 10, 16132, Genoa, Italy
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